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Takayasu's arteritis in children
E Morales1, C Pineda, M Martínez-Lavín
1Instituto Nacional de Cardiologia Ignacio Chávez, México City, Mexico.
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Takayasu
Area of Science:
- Pediatrics
- Rheumatology
- Infectious Diseases
Background:
- Takayasu's arteritis (TA) is a large vessel vasculitis.
- Pediatric TA often presents differently than adult-onset disease.
Purpose of the Study:
- To describe the clinical features of TA in children.
- To identify potential associations and treatment outcomes.
Main Methods:
- Retrospective review of 26 pediatric patients diagnosed with Takayasu's arteritis.
- Analysis of clinical manifestations, laboratory findings, and treatment responses.
Main Results:
- Systemic inflammation was prominent in pediatric TA.
- Eighty-five percent of patients had arterial hypertension.
- High rates of positive purified protein derivative (PPD) and lymphadenopathy suggested a possible link with atypical mycobacterial infection.
- Corticosteroid therapy showed no improvement in arterial obstruction.
- The 5-year mortality rate was 35%.
Conclusions:
- Pediatric Takayasu's arteritis is an aggressive, potentially lethal condition.
- Clinical presentation in children differs from adults, with prominent systemic inflammation.
- Further research into the potential link with mycobacterial infections is warranted.
Abstract:
We reviewed the clinical features of 26 children with Takayasu's arteritis. In contrast to what is often seen in adults, in this age group inflammation of different systems is a conspicuous feature. Eighty five percent of cases had arterial hypertension. The high incidence of arthritis and heart failure provoked confusion with rheumatic fever. There was a high frequency of positive purified protein derivative (73%) and lymphadenopathy (38%) with a histological picture of caseating granulomas, suggesting a link between Takayasu's arteritis and an atypical mycobacterial infection. No improvement of the arterial obstruction was observed with corticosteroid therapy. Takayasu's arteritis in children presents as an aggressive often lethal disease. The mortality rate was 35% over an observation period of 5 years.